Abstract 1720P
Background
Real-world data for the treatment of advanced oesophageal squamous cell cancer (aOSCC) in a Western population is limited. In addition, few data exist for survival with supportive care alone (BSC). This knowledge is important for patients and clinicians to personalise treatment. The aim of our study was to report survival with BSC alone in patients diagnosed with aOSCC in our region.
Methods
Patients in NHS Tayside, Scotland, diagnosed with OSCC between 01/01/2011-31/12/2020 were retrospectively identified from pathology records. Clinical data was obtained from electronic records. Patients treated with radical intent were excluded. Patients in the BSC group either chose not to have active treatment or were deemed not suitable. Kaplan-Meier analysis for survival was performed to determine median overall survival (mOS) and Cox Regression analysis used to determine contributing factors. Local ethical approval was obtained.
Results
219 patients were diagnosed with OSCC during the time period with 52% being female. 169 (77%) were treated with palliative intent; 22 (16%) received palliative chemotherapy (CTx) as their primary treatment and 94 (57%) received BSC alone. Those who received CTx were younger (median age 63 vs 79 years, p=0.054) and had better ECOG performance status (PS) (p<0.0001). mOS was 10.7 vs 3.9 months (p=0.0036) for CTx and BSC respectively. Cox regression analysis in the BSC group identified greater stage, poorer PS and male sex as predictive of shorter survival. 36% of BSC patients required a stent for dysphagia. Table: 1720P
| Palliative CTx (n=22) | BSC alone (n=94) | p-value | |
| Age (years, median(range)) | 63 (38-83) | 79 (39-95) | 0.054 |
| Sex Male Female | 8 (41%) 14 (59%) | 45 (48%) 48 (51%) | 0.44 |
| mOS (months) | 10.7 (8.7-17.3) | 3.9 (3.2-5.9) | 0.0036 |
| ECOG PS 0 1 ≥2 Unknown | 6 (27%) 9 (41%) 3 (14%) 4 (18%) | 0 (0%) 9 (10%) 8 (8%) 77 (82%) | <0.0001 |
| TNM8 Stage 1/2 3 4a 4b Unknown | 1 (5%) 2 (9%) 4 (18%) 14 (64%) 1 (5%) | 11 (12%) 10 (11%) 32 (34%) 18 (19%) 23 (24%) | 0.001 |
| Stent required | 6 (27%) | 34 (36%) | 0.47 |
Conclusions
To our knowledge this is the largest UK study of outcomes in aOSCC treated with BSC only - mOS in our cohort was approximately 4 months. Stage, ECOG PS and patient sex play a role in prognostication in this setting. Our data highlights the difference between real-world and trial populations.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
R. Petty: Non-Financial Interests, Personal, Invited Speaker: Eli Lilly; Non-Financial Interests, Personal, Advisory Role: Eli Lilly; Non-Financial Interests, Personal, Invited Speaker: BMS; Non-Financial Interests, Personal, Advisory Role: BMS; Non-Financial Interests, Personal, Invited Speaker: Pfizer; Non-Financial Interests, Personal, Advisory Role: Pfizer; Non-Financial Interests, Personal, Invited Speaker: Sanofi; Non-Financial Interests, Personal, Advisory Role: Sanofi; Non-Financial Interests, Personal, Invited Speaker: Servier; Non-Financial Interests, Personal, Advisory Role: Servier; Financial Interests, Institutional, Research Grant: AstraZeneca; Financial Interests, Institutional, Research Grant: Roche; Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Institutional, Research Grant: Merck; Financial Interests, Institutional, Research Grant: Eli Lilly; Financial Interests, Institutional, Research Grant: Five Prime Therapeutics; Financial Interests, Institutional, Research Grant: Clovis; Financial Interests, Institutional, Research Grant: Boston Biomedical; Financial Interests, Institutional, Research Grant: Janssen. All other authors have declared no conflicts of interest.